Sleep Hygiene

1. Get up at the same time each day regardless of bedtime. It keeps the biologic clock 'set' or entrained.

While often you cannot control when you fall asleep, you can control when you wake up. To create a routine, this is the easiest place to start.

2. Keep the bedroom environment comfortable including noise free and at a comfortable temperature.

A different mattress or pillow can make a world of difference (often only realized after a change) and should be considered to maximize good sleep. The correct temperature of the room is open to debate but cooler is typically better to reflect your core body temperature in the deepest stages of sleep. The darkness of the room can be corrected with window shades or an eye mask, a fan, earplugs or a white noise machine may help with outside noise.

3. Sleep only as much as you need to feel rested as excessive time in bed may cause fragmented sleep.

The weekends or days off may induce you to stay in bed and “catch up” on your sleep. It is not possible to actually “catch-up” and often the extra time in bed makes you feel sluggish. Children and adolescents need approximately 9-12 hours of sleep each night. Adults and the elderly generally require between 7 and 9 hours of sleep. Some people function well on much less sleep while others need more. It is important to find the best sleep schedule for you (based upon how you feel the next day) and try to plan on that amount of time to sleep. Often if you are depressed you may not feel that you had enough sleep and stay in bed. This leads to a cycle of non-restorative sleep and increased symptoms of depression. A standardized wake time, which includes getting out of bed, will assist in establishing a good routine.

4. Reduce or eliminate caffeinated products.

People react to caffeine differently. While some may be able to drink caffeine in the late afternoon or evening and have no trouble sleeping, others may need to stop drinking caffeinated drinks after breakfast. It is important that you remember that tea, sodas, and chocolate contain caffeine and even though you may give up coffee, the substitutions may be just as potent. It is helpful for you to maintain a food and beverage journal to help track caffeine intake.

5. Exercise regularly but not within three hours of sleep.

Exercise in general makes it easier to fall asleep and to sleep more soundly, as well as providing many other health benefits. It is important to remember that exercise raises your body temperature and your body temperature needs to be cooler to fall asleep. If you suffer from insomnia, scheduling exercise earlier in the day may improve your sleep onset.

6. Eat regular meals and do not go to bed hungry or overly full, as both conditions may disturb sleep.

Mother was right in offering a snack before bedtime. A small snack can alleviate hunger pangs which may cause difficulty falling asleep. On the other hand, a large, heavy meal near bedtime or even spicy foods that may cause heartburn can make you less comfortable when preparing for sleep.

7. Avoid excessive liquids before sleep as this may cause an increased need to wake up to urinate at night.

Some people find decaffeinated teas or milk soothing to assist in falling asleep and the benefit may off-set the inconvenience of getting up in the night. Others need to stop drinking anything early in the evening. Diuretic therapy before bed should be discussed between you and your physician as it may be contributing to nocturnal awakenings.

8. Avoid alcohol prior to sleep.

Alcohol is known to be widely used by individuals to help fall asleep. The problem is that alcohol becomes a sleep irritant later in the night. After its initial sedative effects subside, alcohol creates middle of the night awakenings and a difficulty falling back to sleep.

Nicotine is a stimulant and will disrupt your sleep. This is important to be aware of so you do not smoke during your nighttime awakenings.

10. Avoid going to sleep when angry or worried.

Stress is a significant contributor to insomnia. Avoid arousing or stressful activities like working, paying bills or family problem-solving before bedtime. It is important to utilize good behavioral modification techniques, such as relaxation, in the evening to reduce tension prior to sleep. Keeping a notebook by the bedside to write down thoughts or concerns is also a good solution to prevent a fixation on issues. Often an answer will come to you during sleep or will be obvious in the morning, but not sleeping, it will only add to next-day consequences of being unable to deal with stressors or causing a lack of concentration.

11. Don't watch the clock or try to fall asleep.

If you cannot go to sleep within 20 minutes, you should get out of bed and do something which is non-stimulating, such as reading a book in a quiet room or listening to soft music. Turning the clock around so that you are unable to see the time and trust that the alarm will wake you. This avoids the frustration of counting the time you have left to sleep.

12. Use the bedroom for sleep and sexual activity only.

It is best to take work materials, computers and televisions out of your sleep environment. Light from the computer screen or TV creates a false daylight effect and may add to your difficulties in falling asleep. Work materials may present a constant reminder of worries which can interrupt sleep. It is best to create a room that focuses only on the actual activities desired.